ABSTRACT

The most common modality of speech rehabilitation after total laryngectomy is insertion of voice prosthesis after tracheoesophageal puncture (TEP). The aim of this study is to analyze whether preoperative radiotherapy (RT) has an effect on the complication and speech success rates in patients with primary TEP.

The study included 124 patients who underwent total laryngectomy and primary TEP for laryngeal carcinoma. The patients were analyzed in two groups, patients who underwent primary surgery (Group 1) and patients who received preoperative RT (Group 2).

Saliva leakage around the prosthesis occurred in 20 (19.4%) of the patients who underwent primary surgery (Group 1) and in 12 (57.1%) of the patients who received preoperative RT (Group 2) (p=0.01). The difference was statistically significant. Speech could be achieved in 76.6% of the patients in Group 1 and in 76.1% of the patients in Group 2. When comparing the initial time of speech, no statistically significant difference was observed between two groups.

The major advantage of primary TEP is that greater exposure and access at the time of original surgery preclude the likelihood of major complications in the visceral compartment such as esophageal perforation and mediastinitis. Necrosis of the posterior wall of trachea and leakage around the prosthesis were the main early and late complications when primary TEP was performed in preoperatively radiated patients.

Keywords: Total Laryngectomy, Tracheoesophageal Puncture, Voice Rehabilitation